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Environmental Health Department <br /> <br />Total Attendant <br />| <br />3Number of dumpsters: <br />APPLICATION <br />1. <br />2. <br />Date: i Event Coordinator: <br />I <br />3 1 <br />i <br />I <br />I <br />II <br />2. <br />3. <br />4. <br />5. <br />6. <br />5. <br />6. <br />Is potable water supplied and available for each food vendor: <br />Is electricity supplied and available for each food vendor: <br />Are janitorial facilities available: <br />Number of toilets provided: <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br /> No <br /> No <br /> No <br />I <br />1 <br />i <br />J <br />S <br />.(\A- <7^3^ <br />■ <br /> //).:, <br />^9 <br />SAN JOAQUIN <br />-----COUNTY------- <br />Grcotness grows here. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the <br />event. <br />I understand that as a temporary event coordinator, I am responsible for meeting California State <br />standards and the EnvironmentalLHealth Department policies and procedures. <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />07/01/2025 <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />a) Temporary Event Application <br />b) Application Review Fee of $179 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $179 per hour (weekdays 8:00 am to 5:00 pm) <br />• After regular business hours (weekday, weekends and holidays) the inspection is charged at a <br />minimum three-hour overtime rate of $805.50 <br />application Is to be completed and signed by the Event Coordinator, then returned to the <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />Average Age: S <br />l —p <br />[^Yes <br />[jQYes <br />^Yes <br />/Jr, <br />-----------------------------.... UKMAI IUN . . ___ <br />Name of Event: F tiMrt- rMT?: / ip P/nn \ <br />Date(s) of Event: Time of Evenly <br />Location: A\ / | | f", A} r I ------------------- <br />Event Coordinator (Name):. AA A r Telephone: (J^) <br />Mailing Address: I Art € <br />Number of Food Booths: X <br />Approximate attendance at peak time: